Efficacy of contrast-enhanced US versus CT or MRI for the therapeutic control of percutaneous radiofrequency ablation in the case of hepatic malignancies

Ultraschall Med. 2011 Apr;32(2):148-53. doi: 10.1055/s-0029-1245934. Epub 2011 Jan 11.

Abstract

Purpose: The goal of this study was to assess the informative value of contrast-enhanced ultrasound after radiofrequency ablation (RFA). Patients who had undergone RFA of malignant liver tumors were followed up with contrast-enhanced sonography (CEUS), computed tomography (CT) and/or magnetic resonance tomography (MRI), and the outcomes were compared.

Materials and methods: 76 patients undergoing 194 RFAs for 118 hepatic neoplasms (n = 55 HCC, n = 63 metastases) in the course of a 7-year period were examined post-interventionally using CEUS and CT or MRI. During follow-up (gold standard of evaluation), contrast agent rim accumulations with a diameter greater than 5 mm and a growth rate of at least 25 % were counted as a recurrence.

Results: CEUS-CT comparison group: A total of 65 scan pairs were compared. In 54 cases (83.1 %) the findings were the same with either method. In 7 cases (10.8 %) CEUS confirmed the correct diagnosis, and in 2 cases (3.1 %) only CT was correct. In 2 cases (3.1 %) both methods yielded incorrect results. Diagnostic accuracy (DA): CEUS 93.8 %, CT 86.2 %. CEUS-MRI comparison group: In 23 cases (88.5 %) of a total of 26 scan pairs, the findings were the same for both CEUS and MRI. In 3 discordant cases only CEUS confirmed the correct diagnosis (3 cases, 11.5 %). Diagnostic accuracy DA (n = 26): CEUS 100 %, MRI 88.4 %.

Conclusion: CEUS performs equally to CT and MRI in the follow-up of patients treated for liver tumors by RFA.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation / methods*
  • Contrast Media / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted*
  • Liver / pathology
  • Liver / surgery
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm, Residual / diagnosis
  • Neovascularization, Pathologic / diagnosis
  • Neovascularization, Pathologic / surgery
  • Phospholipids*
  • Postoperative Complications / diagnosis*
  • Sensitivity and Specificity
  • Sulfur Hexafluoride*
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Ultrasonography*
  • Ultrasonography, Interventional*

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride